Jake Paul Fratkin, OMD, L.Ac. From Acupuncture Today, January 2017, Vol. 18, Issue 01
Kidney yang, if we include mingmen fire, is the energy and heat source for the whole body. Jing is the essence of yang, and is stored in kidney, the extraordinary channels, and in bone marrow, which in TCM includes the brain. In modern physiology, kidney yang and jing empower the adrenal glands, testes and ovaries, as well as influence the entire endocrine system.
Kidney yang extends to all organs. First, it pumps qi and yang to the upper burner, affecting heart and lung. Kidney yang keeps the heart beating and keeps the blood warm. If kidney yang is weak, the heart gets cold, leading to congestive heart failure. Kidney yang also roots the lungs, allowing the diaphragm to descend on inhalation. Weakness can precipitate asthma. When the yang of the upper jiao is affected, fatigue and low vitality follow, as well as poor concentration or forgetfulness.
Second, kidney yang provides the energy for digestive peristalsis, helping move food through the digestive tract. It also warms and nurtures stomach fire and spleen yang, directly boosting hydrochloric acid, and thereby aiding digestive strength. Deficiency can contribute to sluggish metabolism, constipation, and poor absorption of nutrients. In extreme cases of yang deficiency, the intestines lose their contractile strength, causing diarrhea or cramping upon waking (“daybreak diarrhea”).
Third, kidney yang and jing affect urogenital function. It governs the ability to constrict the urethra, and deficiency can lead to urinary dribbling or frequency. Yang deficiency often contributes to swollen prostate and lower leg edema. It also controls erection and ejaculation, and deficiency leads to impotence or poor sexual function for men. In extreme cases, spontaneous leakage of semen without erection or ejaculation can occur (spermatorrhea). For these reasons, yang and jing tonics are used to enhance male sexual performance and fertility. Also, because kidney yang warms the uterus, it can underlie cases of female infertility, amenorrhea and other menstrual issues. Formulas for yang and jing can also be useful for postpartum fatigue.
Fourth, weakness of kidney yang is often the cause of weak lumbar area, chronic back problems, degeneration of spinal discs, and knee pain or degeneration. As kidney nourishes and controls the bone, osteoporosis is usually due to kidney deficiency (yang, yin and jing.)
Fifth, kidney yang, along with kidney yin, helps to regenerate marrow and create blood, and some cases of blood deficiency are due to kidney deficiency. Radiation depletes kidney yang, and tonification of yang, yin and blood is often required following radiation. Yang, yin and jing deficiencies can lead to dementia and other brain degenerative illnesses. The brain is also considered bone marrow in TCM!
Kidney yang and mingmen strength is initially determined by one’s constitution. As we age, we use up our supply of yang and jing, leading to diminished organ function and becoming cold from poor circulation. Lowered warmth and fire can lead to blood stagnation, and many diseases of the aged are due to blood stagnation rooted in yang deficiency. It is quite common for Chinese, especially men, to take kidney yang tonics as they age. The yang can also be depleted by prolonged illness, surgery, etc.
It is recommended that kidney yang and jing tonics not be used during the early stages of pathogenic wind (common cold), as they tend to drive pathogenic wind deeper into the body. Because of the warming and drying nature of these formulas, they should not be used in cases of deficiency fire or deficiency of yin.
Classical Formulas. There are several classical formulas for yang and jing in common use, manufactured by numerous manufacturers. One that is most often used (although I think there are better), is Jin Gui Shen Qi Wan, “Golden Cabinet Kidney Qi Pill”. This is a formula recorded by Zhang Zhong-Jing in the Jin Gui Yao Lue (220 CE), meant to boost kidney qi and yang. It is good for weak lower back and urinary dysfunction due to yang deficiency. It is an eight-herb formula, becoming very famous many centuries later, where, by removing the two warming herbs (rou gui, Cortex Cinnamomi and fu zi, Radix Aconiti Lateralis Prep), it became the foundation kidney yin tonic, Liu Wei Di Huang Wan, authored by Qian Yi in 1119. It is a gentle formula, not too warming, that gently promotes kidney yang and qi. (Complete ingredients and description for Jin Gui Shen Qi Wan can be found in Fratkin, Essential Chinese Formulas, 2014, p. 560)
A more robust classical formula is You Gui Wan, “Right Restoring Pill”, authored by Zhang Jing-Yue in 1624. Borrowing five of the herbs from Jin Gui Shen Qi Wan, it goes on to add additional herbs to support kidney yang (tu si zi, Semen Cuscutae and du zhong, Cortex Eucommiae), which help to support a weak lumbar area, while dang gui, Radix Angelicae Sinensis and gou qi zi, Fructus Lycii support blood and yin, which help nourish the tendons. In this regard, You Gui Wan is better for lumbar or waist weakness, while Jin Gui Shen Wi Wan is preferred for cold patterns with urinary disturbance. The original formula calls for lu jiao jiao, Colla Cornus Cervi, a boiled-down gelatin made from deer antler (lu rong, Cornu Cervi Pantotrichum). It is an important ingredient for nourishing yang and jing, and benefits male sexual dysfunction as well ad female fertility. Versions from Herbal Times, Kan, and Blue Poppy contain significant amounts of lu jiao jiao, Colla Cornus Cervi, while other versions contain small or none. (For ingredients and description of You Gui Wan, see Essential Chinese Formulas, p. 564)
An often-overlooked classical formula for boosting kidney jing in order to promote male and female fertility is Wu Zi Yan Zong Wan (“Five Seed Develop Family Pill”). Authored by Li Jian-Zhai in 1575, it is available from Plum Flower as “Five Ancestors Teapills”, as well as Guang Ci and Herbal Times, by it’s Chinese pinyin name. This formula boosts kidney qi by combining tu si zi, Semen Cuscutae, a yang tonic, with gou qi zi, Fructus Lycii a yin, blood and jing tonic. Three herbs astringe the formula into the kidneys and direct the formula to the genital organs. (For ingredients and description, see Essential Chinese Formulas, p. 562)
Modern Formulas. Patent medicines from China that are GMP (Good Manufacturing Practice) are still available in Chinese herb stores, as well as distributors such as Nuherbs (California) and Golden Needle (North Carolina). Among my favorites for promoting kidney jing and yang are the Ge Jie formulas. Three different Ge Jie formulas are available, all using dried gecko lizard, considered a very yang medicinal. Ge Jie Bu Shen Wan, “Gecko Tonify Kidney Pill”, has eight ingredients, the smallest of the three, with 28% gecko, supported by yang and qi herbs. Ge Jie Da Bu Wan, “Gecko Large Tonifying Formula”, contains eighteen herbs, again tonifying yang and qi. In this formula, gecko contributes 22% of the formula. Plum Flower’s “Gecko Tonic Pills” contains seventeen herbs, with gecko contributing 6% of the formula. Complete ingredients and indications can be found in Essential Chinese Formulas, p. 567.
American companies are offering unique and dedicated formulas for kidney qi and yang. Health Concerns has Adrenosen and Virility Tabs; Evergreen has Adrenoplex, and Vitality for Men; Golden Flower offers Nourish Essence Formula, and Vital Treasure Formula; Guang Ci (Active) has Zhuang Yang Wan and Huan Shao Zhuang Yang; Kan has
Jade Treasure Clear, Jade Treasure Cool, and Jade Treasure Support; and Seven Forests offers four different formulas: Cord Tablets, Epimedium 8, Eucommia 18, and Man’s Treasure. Their online and paper catalogues will carry ingredients and indications.
Finally, not to be forgotten are the wonderful yang and jing tonics offered in the Chinatown herb stores. Many of these are described in my first book book, Chinese Herbal Patent Medicines (2001). They include the following: Ginseng Antler Extract, Shou Wu Chih, Ginseng Antler Extract, Deer Tail Extract, Kwei Ling Chi, Kang Wei Ling, Nan Bao Capsules, and Tzepao Sanpien Extract.
Conclusion. The yang and jing tonics are most clinically applicable to diminished sexual function or vitality in men as they age beyond 55 years old or so. They are commonly taken by men as they age in China. The formulas are also beneficial in female infertility due to yang deficiency, and to enhance poor sperm count, motility or morphology in male fertility issues. As one can see, the modern American clinician has many herbal options to help support kidney yang and jing function.